Abstract
BackgroundDespite rapid discoveries in molecular biology of renal cell carcinoma (RCC) and advances in systemic targeted therapies, development of new diagnostic and therapeutic strategies is urgently needed. The androgen receptor (AR) has been shown to hold prognostic and predicitve value in several malignancies. Here, we studied a possible association between AR expression and prognosis in patients with RCCs.ResultsLow AR expression levels were associated with occurrence of distant metastasis and higher tumor stage in papillary and clear-cell RCCs. Importantly, multivariate Cox regression analyses revealed that AR is an independent prognostic factor for cancer-specific survival.Materials and MethodsThe expression of AR was measured by immunohistochemistry and assessed by digital image analysis using a tissue microarray containing tumor tissue of a large and well-documented series of RCC patients with long-term follow-up information. Chi-squared tests, Kaplan-Meier curves and Cox regression models were used to investigate the possible relationship between AR expression and clinico-pathological characteristics and patient survival.ConclusionsPatients affected by AR-positive tumors exhibit a favorable prognosis by multiple Cox regression, while loss of AR expression is related to aggressive disease. Therefore, assessing AR expression offers valuable prognostic information that could improve treatment selection for metastatic disease. Moreover, our findings highlight a potential therapeutic use of AR pharmaceuticals in patients with RCCs.
Highlights
Recent insights into the biology of renal cell carcinoma (RCC) have led to the introduction of novel targeted therapies for kidney cancer
Low androgen receptor (AR) expression levels were associated with occurrence of distant metastasis and higher tumor stage in papillary and clear-cell RCCs
Patients affected by AR-positive tumors exhibit a favorable prognosis by multiple Cox regression, while loss of AR expression is related to aggressive disease
Summary
Recent insights into the biology of renal cell carcinoma (RCC) have led to the introduction of novel targeted therapies for kidney cancer. Barboro et al reported that a high percentage of AR-positive cells is associated with a good prognosis in prostate cancer patients [8], there are conflicting results and the prognostic value of AR expression in prostate cancer and its clinical relevance is still debated [9]. High AR expression is associated with lower recurrence rates and better prognosis in bladder cancer [11] and improved survival in serous carcinoma of the ovary [12], advanced squamous cell carcinoma of the head and neck [13], and breast cancer [14]. Despite rapid discoveries in molecular biology of renal cell carcinoma (RCC) and advances in systemic targeted therapies, development of new diagnostic and therapeutic strategies is urgently needed. We studied a possible association between AR expression and prognosis in patients with RCCs
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